Abstract:
Background. Systemic lupus erythematosus (SLE) is strongly associated with increased
cardiovascular (CV) risk, due to both traditional risk factors and disease - specific immune
mechanisms such as endothelial dysfunction and antiphospholipid antibodies. Early and
personalized assessment is essential.
Objective(s). To evaluate current evidence about the prevalence and mechanisms of CV risk
in patients with SLE, with a focus on disease-specific immunological factors and their
implications for clinical practice.
Materials and methods. A narrative review of the recent literature was conducted,
including articles published between 2014 and 2023. Clinical studies and meta-analyses
investigating the incidence of cardiovascular events in patients with Systemic Lupus
Erythematosus, as well as both traditional and disease-specific risk factors, were analyzed.
Results. Patients with SLE have an increased risk of myocardial infarction and stroke, up to 50 times higher in women under 50 compared to the general population. In addition to
traditional risk factors (hypertension, obesity), autoimmune mechanisms such as
antiphospholipid antibodies, immune-mediated endothelial dysfunction, and neutrophil
activation play a key role in atherogenesis. Standard cardiovascular risk scores tend to
underestimate the real risk in systemic lupus erythematosus. Current discussions
emphasize the need for more sensitive screening tools and early, individualized
interventions targeting modifiable risk factors.
Conclusion(s). SLE significantly increases cardiovascular risk through traditional factors
and disease-specific autoimmune mechanisms. Standard assessments often underestimate
this risk, making personalized monitoring and early interventions essential to prevent
complications and improve patient outcomes.
